Evidence map›Paper›PMID 41436111›Full record

ArticleJournal of oral & facial pain and headache2025

Dimensionality and reliability of the Epworth Sleepiness Scale in dental patients referred for oral appliance therapy.

Ksenija Rener-Sitar, Mike T John, Dennis P Haley, Anthony J DiAngelis, Michael J Howell, Snigdha S Pusalavidyasagar

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Article in Journal of oral & facial pain and headache, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Ksenija Rener-SitarDivision of Oral Medicine, Diagnosis and Radiology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA.
Mike T JohnDivision of Oral Medicine, Diagnosis and Radiology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA.
Dennis P HaleyDepartment of Dentistry, Hennepin Healthcare, Minneapolis, MN 55414, USA.
Anthony J DiAngelisDepartment of Dentistry, Hennepin Healthcare, Minneapolis, MN 55414, USA.
Michael J HowellDepartment of Neurology, School of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.
Snigdha S PusalavidyasagarDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, School of Medicine, University of Minnesota, Minneapolis, MN 55455, USA.

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6 · The paper itself

Abstract

backgroundThere is a limited amount of published research on the dimensionality and reliability of the Epworth Sleepiness Scale (ESS) questionnaire for adult patients referred for oral appliance therapy. This information is crucial for dentists, who often lack objective measures of sleep-disordered breathing (SDB) during titration process of an oral appliance. This study investigated the dimensionality and reliability of ESS scores in adult dental patients with SDB undergoing oral appliance treatment.

methodsIn 103 dental patients with SDB referred by a physician (mean age: 52.3 ± 13.0 years; 35% female), the dimensionality of the ESS was investigated using exploratory (EFA) and confirmatory factor analyses (CFA) to determine how many scores are needed to characterize the construct. ESS questionnaires were administered twice before treatment. Internal consistency and test-retest reliability were assessed.

resultsHorn's parallel analysis suggested a one-factor model. Extracting one factor and standardizing loadings led to strong loadings for all items, ranging from 0.53 to 0.82. The fit indices indicated a good model fit (Comparative Fit Index = 0.999, Root Mean Square Error of Approximation = 0.020, and Standardized Root Mean Square Residual = 0.064). Cronbach's alpha with 95% confidence interval (CI) was 0.85 (0.82-0.88), indicating strong internal consistency. The intraclass correlation coefficient type 2,1 (95% CI) was 0.86 (0.79-0.90), and the weighted kappa ranged from 0.50 to 0.81.

conclusionsIn this patient population, the ESS reliably characterizes excessive daytime sleepiness with a single score and appears suitable for individual assessment in dental patients undergoing oral appliance treatment for SDB.

Indexed as

Sleep Apnea SyndromesAdultAgedFemaleHumansMaleMiddle AgedReproducibility of ResultsSurveys and QuestionnairesDental sleep medicineDimensionalityEpworth Sleepiness ScaleExcessive daytime sleepinessFactor analysisObstructive sleep apneaOral applianceQuestionnaireReliabilitySleep-disordered breathing

Identifiers

PMID41436111
PMCPMC12727181

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